Current Status of Federal Mental Illness Insurance Parity Legislation

September 23, 2008

With only a week left before projected final adjournment, the House and Senate are at risk of a procedural impasse over long awaited legislation to require health plans to cover mental illness and substance abuse treatment on the same terms and conditions as all other illnesses.Today both the House and Senate passed the final agreement on parity legislation.By a vote of 84-11, the Senate approved the parity bill (known as the Paul Wellstone-Pete Domenici Mental Health Parity and Addiction Equity Act of 2008) as an amendment to an omnibus package extending expiring tax breaks.Later the House followed by passing the mental illness insurance parity bill (HR 6983) by a vote of 376-47, as separate free-standing legislation.

It important to note that this is stand-off is completely unrelated to the actual provisions in the parity legislation, which House and Senate leaders agreed to back in June.Instead, the impasse is related to whether to pass the compromise as a free-standing bill or to attach it to an unrelated measure extending expiring tax provisions.In addition, the House and Senate are taking different approaches on the budget "offsets" needed to "pay-for" the bill (see below).

The rules of the House allow the majority enormous flexibility to move bills quickly through the chamber.By contrast, the rules of the Senate allow any single senator enormous leverage to block individual bills – thereby often requiring bills to be combined into larger legislative packages to overcome the objections of a single senator.Thus, a free-standing parity is highly vulnerable to being blocked in the Senate.Likewise, a large omnibus tax package (with parity attached to it) is expected to draw objections in the House.

Bottom Line for NAMI – After nearly 20 years of pursuing parity legislation, victory has never been closer.It is simply unacceptable for procedural disputes to get in the way of this critical legislation.Thus NAMI is demanding that the parity bill not be held hostage to procedural fights between the House and Senate.

What is in the Parity Agreement?

Click here to read a memo outlining the agreement that the sponsors of the parity legislation – Senators Domenici, Kennedy and Enzi and Representatives Kennedy and Ramstad – reached back in June.This includes an explanatory note about the budget "offset" required as part of the bill to "pay for" revenue lost to the Treasury as a result of eliminating restrictions on coverage that currently exist in group health plans for mental illness and substance abuse treatment.